在食道状细胞癌的化学放射治疗后,对临床完全响应者进行积极监测
Carlo A De Pasqual1, Jacopo Weindelmayer1, Maria C Gervasi1
1Department of General and Upper Gastrointestinal Surgery, University of Verona, Verona, Italy.
The British journal of surgery
|February 28, 2024
概括
积极监测是食道状细胞癌 (SCC) 患者的安全选择,在化疗放射治疗后获得临床完整反应 (cCR). 这种方法显示了可比的生存率和比立即手术更低的整体复发率.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 目前对食道状细胞癌 (SCC) 的指导方针建议进行新辅助化疗放射治疗,然后进行手术或绝对化疗放射治疗.
- 在选择主动监测的化学放射治疗后获得临床完整反应 (cCR) 的患者的评估结果至关重要.
研究的目的:
- 评估在食管SCC患者中积极监测的可行性和安全性,这些患者在化学辐射治疗后获得了cCR.
- 为了比较活跃监测和计划手术组之间的生存率和复发率.
主要方法:
- 用化学放射治疗治疗的食道SCC患者的回顾性分析 (2016年1月 - 2022年6月).
- 在接受主动监测的患者与计划性手术后cCR的患者之间的生存和复发的比较.
- 卡普兰-梅尔生存分析和日志等级测试用于组比较.
主要成果:
- 与手术组相比,积极监测患者年龄较大,食道上/中三瘤更多.
- 活跃监测组 (70%) 与手术组 (58%,P=0.02) 的三年无进展生存率显著更好.
- 总体生存率 (3年:50%对59%,P=0.55) 和总体复发率 (19.4%对32.6%,P=0.26) 在各组之间是可比的. 在监测组中,局部复发率更高,而在手术组中,系统复发率更高.
结论:
- 积极监测是食道SCC患者在化疗和放射治疗后实现cCR的可行和安全的策略.
- 这种方法提供了与手术相比的生存结果,可能有更好的无进展生存率.
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